Hospital bed
The hospital bed or clinic bed is a hospital bed that has been adapted to the requirements of the clinical conditions and expanded in its functions. Modern hospital beds are electrically operated and have a built-in rechargeable battery so that the adjustment functions are also available during transport. Hospital beds are used in hospitals , rehabilitation clinics, and retirement homes . The nursing home bed dominates in home care .
The term can also refer to the maximum number of patients possible in such a facility, without referring to the specific object or its number. Rather, it is a factor in hospital planning . (see plan bed )
Requirements, standards
Hospital beds are medical devices ; As such, they are subject to the German and Austrian medical device laws and the associated operator regulations , which, as an implementation of the EEC directive 93/42, ensure standardization within the EU , and to the standard EN 60601-2-52 , which ensures operational safety for Patients and operators guaranteed. Also relevant for Germany is DIN VDE 0751-1 ("Repeat tests and tests before the commissioning of medical electrical devices or systems"). Hospital beds as active, i.e. energetically operated medical products may only be used by persons who are qualified for this and have been instructed in the use of the respective device type. They are made of metal (mostly steel) and plastic. This guarantees insensitivity and easy cleaning. They must be able to move on rollers and also be controllable by engaging a pair of rollers, and it must also be possible to safely locate them on sloping ground. The possibility of machine cleaning in the bed control center of a hospital , in which beds are cleaned and reprocessed, simplifies the processes within the company and improves hygiene by preventing cross-infections .
properties
Hospital beds have a metal frame on which the respective mattress is placed. You don't have a slatted frame , but rather a bit of flexible wire mesh or a plastic plate under the mattress. The chest compressions are made easier and components made of wood are avoided. The lying area is generally divided into three parts, often 1 m wide and 2 m long. The weight of a modern hospital bed is around 140 kg. Depending on the model, it is possible to pull out the foot section and lengthen the bed so that it can also be adapted for patients with an above-average height. The manufacturers also specify a maximum patient weight up to which they guarantee safety. If you weigh more than 175 kg, you need a special bed. Head and foot sections at the ends of the bed are designed in such a way that they can be removed quickly and easily, for example in order to have better access to the patient during endotracheal intubation .
Since hospital beds are mobile, they usually have rubber wall spacers that prevent hard knocks and damage to the bed or its surroundings that are unpleasant for the patient if the bed hits the wall during transport. The beds are manually or electrically adjustable, which at least affects the working height and the angle of the headboard. With further adjustment increase the possibilities of the patient's wishes and his illness accordance store , to special bearings as the Trendelenburg position . Electrically adjustable beds have a control panel that is connected to the bed by cable. Depending on the manufacturer and the intended use, there may be another control unit for the hospital staff at the foot end, inaccessible to the patient, which offers the possibility of blocking individual adjustment options that are not beneficial for the patient.
Expandability
Clinic beds can be extended in many ways, depending on the purpose. It is widespread to attach a bed hanger, colloquially known as a "bed gallows", which allows the patient to stand up or pull himself up. Other expansion options include, for example, holders for walking sticks , infusions , drains , extensions , oxygen bottles or other medical devices. Bed side parts, commonly known as “bed rails”, which provide support and orientation for the patient and prevent falling out, are either available separately or are already integrated so that they can be used if necessary. Their continuous use on both sides prevents the patient from getting out of bed unaided and thus already represents a freedom-depriving measure of the restraint of a patient . At the foot end there is often a pull-out shelf that can be used for luggage or laundry.
Special beds
Special versions are available especially for intensive care units . Usually, modern, electrically adjustable beds that can be expanded as described are used there. In individual cases and depending on the indication, air cushion beds can also be used for very overweight and immobile patients, rotary beds for kinetic therapy in severe lung diseases or, rarely, glass ball beds . In the case of air cushion beds, options for temperature control and for weighing the patient are also built in.
Ambulance
The beds are also used for internal patient transports on the hospital premises. For this purpose, most beds have a function in which the wheels at the head end can be locked and the bed can now be pushed by one person at the head end without it breaking out at the sides. The lock is usually set using the pedal at the head or foot end.
Some beds also have an integrated motor that helps you slide the bed. Normally, so-called “ bed movers ” are used for long distances, inclines or heavy patients or beds , which help to push the chair. The advantage of the “Bed Mover” is that it is only hooked in when it is in use, which saves considerable costs when buying a bed.
Hospital beds in some hospitals are also equipped with RFID tags to trigger bed preference for elevators .
resuscitation
Modern beds often have a control element that enables the bed to be brought into the flat basic position very quickly in the event of cardiopulmonary resuscitation . In addition, a hard surface has to be created for the chest compressions, the mattress would give too much. With older beds, the board at the foot end is usually used for this, as the counterpart at the head end cannot be pulled out if there is a " bed gallows ". With newer beds, the footboard can no longer be pulled out; instead, a so-called resuscitation board is placed under the patient . Beds with an air-filled mattress have a removable lock or an emergency button for this purpose, which allows the air to completely escape from the mattress within a few seconds.
Risks
The use of adjustable, engineered and electrically operated beds is not without its risks. In the four years from 1998 to 2002 alone, there were at least 20 deaths in connection with malfunctions in Germany. This is due to problems with electrical safety and the dimensions of side rails with the risk of entrapment and strangulation. The causes are not just manufacturing defects, but also a lack of maintenance and errors by operators and users. In practice, it is sometimes overlooked that the operation of hospital beds as an everyday item is subject to a large number of legal restrictions.
history
As early as the 18th century, beds were invented that were adapted to the special needs of the sick. Beds with adjustable side panels were already in use in England between 1815 and 1825. The development of the hospital bed with a three-part, adjustable lying surface is attributed to the American doctor Willis D. Gatch around 1908. The manual adjustability was followed by hydraulics and the use of electric motors. Electrically controlled beds with control units have existed since 1945. With industrialization and the increase in electrically controlled objects in everyday life, the current state of technology could be achieved, which does not have to be the standard everywhere, even in developed countries for reasons of cost.
Importance to the sick
In the revision course for a nursing textbook, the central importance of the bed for patients with restricted mobility is emphasized:
“For the patient, the sickbed is a place to rest and sleep, a dining and living room and in some cases also a bathroom and toilet, and sometimes a playroom for children. From here the patient participates in his environment and meets relatives, visitors, nurses and doctors. "
Khartoum , 2009
Schkeuditz , 1990
Hospital beds without mattresses, 2008
Sick beds for prisoners in the Guantanamo Bay Naval Base detention center , 2007
Intensive Care Bed, California Intensive Care Unit , 2007
Substructure of a modern, electrically controlled hospital bed
Simplified design of a control unit for the patient
Yellow emergency switch for Trendelenburg positioning and resuscitation, possibility of locking individual functions
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See also
- List of countries by number of hospital beds
- Bed shapes
- Stand-up aid
- Bedsore mattress
- Psychiatric intensive care bed
- Stretcher
literature
- S1 guideline for the hygienic preparation of patient beds of the working group "Hospital & Practice Hygiene" of the AWMF. In: AWMF online (as of 2010)
Web links
- The safe nursing / sick bed; An overview of the rules of technology for nursing / hospital beds . (PDF; 226 kB) VDE medical technology
Individual evidence
- ↑ a b Occupational Safety and Health Saxony, 2002: Safety risks of care beds. (PDF) (No longer available online.) Archived from the original on May 9, 2009 ; Retrieved February 23, 2011 .
- ↑ Dietmar Kirchberg: The Medical Devices Act: what nurses need to know; Regulations, examples, consequences, S58 ff. Schlütersche Verlagsanstalt, 2003, ISBN 3-87706-878-2 ( limited preview in the Google book search).
- ↑ a b Gerhard Münch, Fernande Assa-Schaeffer, Jacques Reitz: Textbook for Nursing: a principle and practice-oriented workbook, p. 120 ff. Walter de Gruyter, 1994, ISBN 3-11-013615-5 ( limited preview in Google Book search).
- ↑ Mitteldeutsche Zeitung of April 30, 2010: When the normal sick bed is not enough. Retrieved February 23, 2011 .
- ↑ The West on August 6, 2009: No sick bed can handle more than 180 kg. (No longer available online.) Archived from the original on December 19, 2009 ; Retrieved February 23, 2011 . Info: The archive link was inserted automatically and has not yet been checked. Please check the original and archive link according to the instructions and then remove this notice.
- ^ A b Friedhelm Henke: Nursing & Gerontopsychiatriererecht 2006. Accessed on February 23, 2011 .
- ↑ Manufacturer example : Bed Mover on hospital beds. Retrieved February 24, 2011 .
- ↑ Video of a bed mover in action. (No longer available online.) Archived from the original on March 1, 2011 ; Retrieved February 24, 2011 . Info: The archive link was inserted automatically and has not yet been checked. Please check the original and archive link according to the instructions and then remove this notice.
- ↑ Workshop of the Münster University of Applied Sciences 2007: Support of logistics processes in the hospital through RFID-supported elevator control (program information). Retrieved February 10, 2013 . ( Page no longer available , search in web archives )
- ↑ Online training for nurses, undated: Problems with cardiac massage; Use of footplate and resuscitation board for resuscitation of patients in bed. Retrieved February 24, 2011 .
- ↑ Bavarian State Ministry for the Environment, Health and Consumer Protection: Safety Risks of Sick and Nursing Beds, 2008. (PDF; 103 kB) Retrieved on February 23, 2011 .
- ↑ Gabriel Christoph Benjamin Busch : Handbook of Inventions, Volume 7 . JG Ernst Wittekindt, Gent 1814 ( limited preview in the Google book search).
- ^ Françoise Boinet: Le lit d'hôpital en France: Étude historique. (Medical dissertation) Paris 1945.
- ^ David J. Bodenhamer, Robert Graham Barrows: The Encyclopedia of Indianapolis . Indiana University Press, Indiana 1994, ISBN 0-253-11249-4 , pp. 609 (English, limited preview in Google Book search).
- ↑ Who Invented The Hospital Bed? Retrieved February 24, 2011 .
- ↑ Life Magazin, November 12, 1945, p. 92 ff. (English) limited preview in the Google book search
- ↑ limited preview in the Google book search
